The Obama administration picked up another legal victory Tuesday as a federal appeals court ruled that employers’ religious rights are not substantially burdened by completing the paperwork in order to opt out of the Affordable Care Act’s contraception benefit.

The ruling came in the Little Sisters of the Poor case, one of the first legal challenges filed by religiously affiliated nonprofits to argue that completing the form to opt out of providing contraception coverage in its employee health plans violated both the Religious Freedom Restoration Act and the First Amendment.

The United States Supreme Court in January 2014 granted the Little Sisters of the Poor’s request for a temporary injunction while the appeals court considered their claims. The Tenth Circuit heard those arguments in December 2014.

The ACA requires some employers to offer health insurance plans that cover contraception as part of a package of preventive care services provided to employees at no additional cost or co-pay. President Obama’s health law includes an exemption for churches and other houses of worship. It also contains an accommodation process for religiously affiliated nonprofits, like Little Sisters of the Poor, that are not churches but maintain a religious objection to providing plans with contraception coverage.

That process allows the objecting employers to complete a form, or otherwise notify the government in writing, of their religious objection and triggers a process whereby the insurance company contracts directly with the people who want contraception coverage at no additional cost.

Little Sisters of the Poor and other religiously affiliated nonprofits argue the task of completing the opt-out form or otherwise notifying the government of their objection substantially burdens their religious rights. In a massive 95-page opinion, the Tenth Circuit rejected this argument outright, holding “[t]he Departments have made opting out of the Mandate at least as easy as obtaining a parade permit, filing a simple tax form, or registering to vote—in other words, a routine, brief administrative task.”

“We conclude the accommodation does not substantially burden Plaintiffs’ religious exercise,” the majority wrote. “The accommodation relieves Plaintiffs from complying with the Mandate and guarantees they will not have to provide, pay for, or facilitate contraceptive coverage.”

Little Sisters of the Poor and other groups argue they should be treated like religious employers and be fully exempt from the contraception coverage requirement. This argument, the Tenth Circuit held, “misconstrues the purpose of religious accommodation: to permit the religious objector both to avoid a religious burden and to comply with the law.”

“We’re disappointed with today’s decision,” Mark Rienzi, senior counsel of the Becket Fund for Religious Liberty and lead attorney for the Little Sisters of the Poor, said in a statement following the decision. “It is a national embarrassment that the world’s most powerful government insists that, instead of providing contraceptives through its own existing exchanges and programs, it must crush the Little Sisters’ faith and force them to participate.”

“To the outside observer it looks like the Becket Fund really wants to be able to argue that the administration is forcing contraception down the throats of nuns,” Lipper said in an interview with RH Reality Check. “Not only [are these cases] weaponizing religious liberty to take away women’s health care, [they are] turning religious liberty into a game of ‘gotcha,’ and I think the courts of appeals are finally starting to push back on this.”

According to the Becket Fund, its attorneys are carefully reviewing the decision before determining those next steps.

Options include appealing the decision to the full Tenth Circuit for review or asking the Roberts Court to step in. “We will keep on fighting for the Little Sisters, even if that means having to go all the way to the Supreme Court,” said Daniel Blomberg, counsel at the Becket Fund for Religious Liberty.

The Becket Fund has filed several requests for Supreme Court intervention in the fight over the ACA accommodation, most recently in July on behalf of Houston Baptist University. In that case, the conservative Fifth Circuit Court of Appeals sided with the administration, ruling the accommodation process was in no way a burden on religious rights.

“The real question right now is are these cases worthy of Supreme Court review,” Lipper said. “Every court of appeals that has looked at these both pre-and-post-Hobby Lobby has rejected them. Under any normal criteria it doesn’t seem like at this point these cases are worthy of Supreme Court review. Whether they’ll go up anyhow, time will tell.”

Hobby Lobby supporters claim that they aren't out to take away contraception, just to keep religious employers from paying for it. Now that the Obama administration has made that possible, however, they are still throwing fits.

When Hobby Lobby sued—and won—for a right to be exempted from the Affordable Care Act regulation requiring employee health-care plans to cover contraception without a copay, the official claim from both Hobby Lobby and its conservative defenders was that this was not an attempt to deprive women of contraception. No, the official argument was that it was simply an attempt by Hobby Lobby’s religious owners not to be party to behavior they consider immoral by “paying for” it.

Well now the Obama administration has created a workaround that more than satisfies the official claim that this isn’t about preventing contraception use; it’s just about not participating in it. All employers who have this oh-so-sincere belief, all they have to do is send in a letter formally declaring that contraception violates their religious doctrines, and they won’t have to pay for it. Instead, the insurance company will just pay directly. No big surprise here. But the supposed defenders of religious liberty are already outraged, because that’s never been what this is about. Rather, it’s about imposing anti-choice dogma on people who don’t agree with it.

If the actual concern was participation in behavior that violates religious principles, then the Obama administration’s new policy should more than address that. All that is required is a statement of principles. People make sincere statements of religious belief in order to get religious exemptions from laws all the time. Conscientious objectors to the draft, for instance, had to make such statements. It’s not considered a burden because there is no shame in expressing a belief you legitimately hold.

If, however, the “sincerely held” argument is a dishonest gambit to cover up for the real goal among much of the right—depriving women of contraception and asserting employer ownership over their private lives—then we can expect that conservatives will reject this new policy. After all, while it meets the stated demand of accommodating religious belief, it does not prevent women from getting affordable contraception outright.

Anyone who has been watching the right become more overtly anti-contraception in recent years can probably guess what is happening: Conservatives are throwing a fit over this. “The government keeps digging the hole deeper,” Adèle Auxier Keim of the Becket Fund, which represented Hobby Lobby in its suit, told U.S. News and World Report. “The government still won’t give up on its quest to force nuns and other religious employers to distribute contraceptives.”

That rhetoric, unsurprisingly, is thoroughly and completely dishonest. First of all, no employer was ever once asked to “distribute contraceptives.” No bowls of Plan B are required at work. No IUD insertions at your desk. For a woman to get contraception, she has to use her insurance plan—the one belonging to her, not her employer—to cover it at a pharmacy. It doesn’t matter if the employer provided it: The employer never had a part in it, no more than if a woman uses her paycheck to purchase condoms.

But now the distance is even greater, since the contraception coverage from the objecting companies isn’t even coming from their employer-offered plans! On the contrary, they are given an opportunity to write a letter declaring how not involved they are. This is strictly between a woman, her doctor, and her insurance company, and the employer doesn’t have anything to do with it.

The Becket Fund is hardly the only source of discontent. TheWashington Times, a conservative paper, went with the headline, “Obama skirts Supreme Court Hobby Lobby birth-control ruling,” a headline that only makes sense if you believe the purpose of the ruling was to deprive women of contraception instead of shield religious employers from participation. Patheos blogger Kathy Schiffer angrily railed, “There’s an ‘accommodation’ which ensures that all women, unless they work for a place of worship, will still get their [copay-free] birth control—even if their employers refuse to pay for it,” and whining about women having “uninhibited sex with no risk of conception.”

This is probably just the beginning of the backlash. After all, when similar rules were written for nonprofits, many of those employers sued anyway, trying to argue that admitting you have a belief can somehow violate that belief if it makes it easier for an employee to get contraception. That argument isn’t performing well in court. Just this week, the Tenth Circuit Court shut it down again, noting that being asked to clarify your beliefs in order to get an exception to a widespread law is not any kind of violation of your rights.

It’s obvious now that employers are trying to seize as much control as they legally can over their workers’ private lives by trying to put as many obstacles as they can between their employees and contraception use. Which is entirely consistent with the overall approach conservatives take on this issue, from pushing for mandatory ultrasounds for abortion to showing up at clinics to harass women. It’s all about stripping women of autonomy and privacy. These employers are just making a naked power grab, using the newness of the Affordable Care Act as an opportunity to inject themselves into a decision that isn’t theirs to make.

Even a popular talking point used to defend Hobby Lobby in the press exposes this privacy-invasion mentality. It was common for right-wing pundits to say that Hobby Lobby covers 16 out of the 20 forms of contraception approved by the FDA, suggesting that women should be grateful for such riches. Never mind that this talking point was simply wrong, as the Supreme Court decision allows employers who have a broader anti-contraception agenda to opt out of health plans that cover any of it. That talking point assumes that your employer should have the power to artificially limit your choices. Imagine if your boss told you that you were no longer “allowed” to use your paycheck to buy broccoli anymore, because he didn’t like it. If he defended himself by pointing out that he still allows you to buy squash and asparagus, that’s no defense at all. It still assumes that he should have final say over how you eat. This talking point was the same: It insidiously pushed the idea that your boss has any business whatsoever telling you what kind of medications to take.

Perhaps this temper tantrum over signing a letter will prove a bridge too far. It does make it impossible to uphold the myth that this was ever about “religious liberty.” For now, for-profit companies who object to contraception haven’t made any further moves. But do not be surprised if they do start suing to gain the ability to interfere with an employee’s right to get contraception coverage elsewhere. Because this was never about religious liberty, but about taking religious and reproductive freedom away from women.

A petition to the U.S. Supreme Court filed by a group of religiously affiliated nonprofits argues that any process that allows employees to access contraception coverage is a violation of employer's rights.

Attorneys representing three religiously affiliated nonprofits challenging the birth control benefit in the Affordable Care Act have asked the U.S. Supreme Court to step in after a federal appeals court ordered they must comply with the law.

The Becket Fund for Religious Liberty filed the request last week on behalf of Houston Baptist University, East Texas Baptist University, and Westminster Theological Seminary. The plaintiffs in East Texas Baptist University argue that the task of completing the government’s form that self-certifies them as religious employers—and eligible for an accommodation to the benefit—“triggers” or “facilitates” the ability of their employees to get contraceptive coverage elsewhere. That, the plaintiffs argue, makes them complicit in what they believe to be a sinful act: supporting contraception generally. A federal district court initially sided with the organizations, but in June the U.S. Court of Appeals for the Fifth Circuit reversed that decision and ruled the organizations had not shown how requesting an accommodation from the requirement substantially burdened their religious rights.

“They sincerely believe that fulfilling the contraceptive mandate via this regulatory option facilitates the provision of contraceptives and abortifacients and makes them complicit in actions that violate their religious beliefs,” the petition said.

Despite hundreds of legal challenges to the accommodation process, so far not a single federal court of appeals has ruled in favor of the nonprofit organizations challenging the Obama administration’s birth control benefit. However, despite the unanimity in the federal appeals courts that the accommodation process does not substantially burden any religious rights, Supreme Court Justice Samuel Alito has revived similar challenges from other religiously affiliated nonprofits, ordering the appeals courts to reconsider their rulings. Those courts did, ruling again in favor of the administration’s accommodation process.

Complicating matters further for the challengers, the Obama administration last week issued final regulations concerning the birth control benefit. The regulations came as a result of the Roberts Court rulings in Hobby Lobby that some secular, for-profit businesses should have available to them an accommodation process if they object on religious grounds to complying with the birth control benefit. They also came following the Court’s interim order in Wheaton College, which allowed for an alternative process for religiously affiliated nonprofits to follow in order to avail themselves of the religious accommodation to the benefit. The new regulations codify those rulings and make available workarounds for those employees whose employers object to complying with the birth control benefit.

“We didn’t go looking for this fight,” said Dr. Robert Sloan, president of Houston Baptist University, in a statement following the filing of the Supreme Court petition. “But here we stand and can do no other. We cannot help the government or anyone else provide potentially life-threatening drugs and devices. The government has many other ways to achieve its goals without involving us. It ought to pick one of those and let us go back to educating our students.”

The Court is likely to consider all of the petitions in late September or early October. If the petition is granted, the case would be argued and decided before the end of the Court’s term in June 2016.

“The exclusion of methods used by men simply makes no sense and benefits no one—not men, not women, not families, not health plans,” Adam Sonfield, author of a new analysis for the Guttmacher Institute on “male” contraceptive methods, said in a statement.

Thanks to the Affordable Care Act (ACA), women who have health insurance don’t have to pay extra for birth control. The same isn’t true for men who want to prevent pregnancy by getting a vasectomy or using condoms—and that’s a serious oversight, according to a leading reproductive health research group.

“The exclusion of methods used by men simply makes no sense and benefits no one—not men, not women, not families, not health plans,” Adam Sonfield, author of a new analysis for the Guttmacher Institute on “male” contraceptive methods, said in a statement.

Vasectomy is one of the most effective contraceptive methods available, Sonfield notes in his analysis—second only to the contraceptive implant, and even slightly superior to intrauterine devices (IUDs) and female sterilization. It’s also less invasive, less expensive, and less risky than female sterilization.

But right now, the ACA creates a financial incentive for couples to choose a tubal ligation for the woman over a much simpler vasectomy for the man.

Condoms are much less effective at preventing pregnancy than any of those methods, but they have the added benefit of protecting against sexually transmitted infections (STIs). Condoms are also most commonly used by teens and young adults who are at higher risk for STIs, and they are typically offered at no cost by programs like Medicaid and Title X family planning.

The original regulatory decision to restrict ACA contraceptive coverage to “female” methods was not “rooted in some sort of animus against men,” Sonfield writes. “Rather, lawmakers’ and advocates’ focus on women’s health issues was in response to their historical neglect.”

Regardless of who technically uses the method, Sonfield notes, women still reap the massive preventive health benefits of being able to plan their pregnancies. That suggests that failing to cover “male” methods is short-sighted from a public health perspective. It’s also a cultural problem because it “perpetuates the all-too-common view that contraception is solely the woman’s responsibility,” Sonfield writes.

About a quarter of women who use contraception rely on a “male” method as their primary means of avoiding pregnancy, according to the report. That’s a total of nine million U.S. women who rely on either male condoms (15 percent of all female contraceptive users) or vasectomies (8 percent) as their primary method of birth control. For comparison, 26 percent of contraceptive users rely on the pill, 25 percent use female sterilization, and 10 percent use either a hormonal or copper IUD.

There are a number of possible solutions to the problem, many of which have obstacles. The least likely option for change would be an act of Congress, whose members’ current conservative bent almost guarantees that “attempts to undermine contraceptive coverage are more likely than attempts to bolster it.”

States could also do something about the problem, and if enough states did so, that could have ripple effects across the entire insurance market. That could be complicated, however. If coverage for “male” methods counted as a “new mandate,” states could be stuck with the bill.

The Obama administration could choose to interpret the ACA provision differently so that methods used by a man also count as preventive care for women. “That would require the administration to amend its current public stance—not something it would do lightly,” the report notes.

Health plans could help by choosing to cover vasectomies without cost sharing, since it would help their bottom line to encourage patients to use cheaper treatments.

“From that perspective, it seems surprising that health plans—which have the authority to go beyond the basic requirements of the ACA—have not yet acted on their own to level that playing field,” Sonfield writes. Condoms would be a tougher sell, though: “Health plans may fear that they will end up simply paying for condoms that people would otherwise pay for out of pocket, rather than actually helping to increase condom use.”

The most promising avenue to fix this coverage gap, according to the Guttmacher analysis, would be for the U.S. Preventive Services Task Force (USPSTF) to issue a specific recommendation on the issue. The ACA automatically incorporates any USPSTF recommendations into its preventive services requirements after a one-year grace period.

“But regardless of the approaches that advocates and policymakers take to bolstering contraceptive coverage, it is time that vasectomy, male condoms and any future methods used by men stop being treated as second class methods just because they are used by men,” Sonfield writes.

Florida’s Republican-led house on Friday ended this legislative session’s debate over whether to use federal Medicaid money toward health-care expansion, voting down a senate proposal 72 to 41.

The vote came during a special session called to decide the budget. House lawmakers ended their regular session days early, citing an impasse over Medicaid expansion in the state. Some Florida Republicans said they opposed Medicaid because it constitutes socialist health-care policy.

On Wednesday of that week, the state senate passed a bill that would have used federal money to help pay for the cost of Floridians’ private insurance, a plan that would have affected about 600,000 low-income people, according to state estimates.

“It’s something we cannot afford, not only in Florida, but in the rest of the nation, if we have government controlled health care,” Rep. Doug Broxson (R-Milton) said during a seven-hour floor debate over the bill on Friday. “History tells us that anything the government is involved in tends to expand. I’m very concerned that we could spend all our gross national product on health care, and it would take away from every other program we have in the state.”

Rep. Jason Brodeur (R-Sanford) said during the debate that “Medicaid is socialized health care insurance,” and creates a “permanent dependency” on handouts, according to the Tampa Bay Times.

The house vote broke down along party lines, with Democrats expressing displeasure during the debate with conservative opposition to providing health care for more low-income families.

“It’s sort of like not taking your heart medicine because you’re waiting for a heart transplant,” said Rep. Jose Javier Rodriguez (D), according to the Miami Herald. “We have to deal with what Florida needs.”

The bill was doomed from the start: The house has maintained its opposition to the Affordable Care Act, and Florida Gov. Rick Scott recently said he would veto an expansion plan if it were to come to his desk.

Scott, a former hospital executive whose company paid more than $600 million in fines for defrauding Medicare, has said he supports Medicaid expansion. But he changed his mind this year, after the federal government said it would stop funding a Florida health program for low-income people.

The governor filed a lawsuit against the Obama administration in April, alleging it was trying to coerce Florida into expanding Medicaid.

He toldPolitico in February that he would not take action if the U.S. Supreme Court guts the Affordable Care Act’s insurance subsidies, saying that it would be a “federal problem.”

Florida has 1.6 million people enrolled in ACA health plans, more than any other state in the country. Nine in ten of those people receive subsidies to pay for their insurance plans.

Stemming the tide of barriers to reproductive health care continues to require significant time and effort from countless dedicated individuals and organizations. It is hard work, but it is work worth doing to ensure that everyone has the ability to choose whether and when to have a child.

Fifty years ago, birth control was illegal and there was no constitutional right to privacy.

Yes, in my lifetime, just 50 years ago.

It was available to many (with the usual caveats that the recipient had resources, lived in a place where it could be obtained discreetly, and so on)—but it was still illegal.

Following the law is generally an important responsibility of all Americans, but bad laws need to be challenged. So 50 years ago the American Civil Liberties Union of Connecticut threw its support behind the successful challenge to the 1879 Comstock Act.

In November 1961, Estelle Griswold courageously opened the doors to a new Planned Parenthood clinic in New Haven and prepared to be arrested. During the clinic’s short tenure, its workers illegally counseled patients on reproductive options and dispersed contraceptives. Within days of its opening, law enforcement predictably arrived to examine the scene.Soon after, police arrested Griswold and her co-conspirator Dr. C. Lee Buxton, a professor at the Yale School of Medicine; both faced criminal charges.

The first step of the plan was complete.

Griswold and a group of Yale lawyers, professors, and doctors, led by attorney Catherine Roraback, used the arrest to oppose the Comstock Act, which banned the use of contraceptives and punished those who aided or counseled the user with a fine of at least $40 or 60 days in prison.

Previous attempts to challenge or modify the rarely enforced law had failed, but this effort successfully landed on the Supreme Court’s docket after moving through the Connecticut state courts. On June 7, 1965, in a landmark decision, Justice William O. Douglas issued the majority opinion in Griswold v. Connecticut, striking down the Comstock Act as unconstitutional.

In Griswold, the Supreme Court recognized a constitutional right to reproductive choice, reading between the lines to locate a privacy right in the “penumbras,” or shadows, of the document. The opinion’s scope is narrow. It declares that a right to privacy exists for (implicitly heterosexual) marital relations—not for individuals. Further, the Court failed to acknowledge the significance of birth control access for gender equality. But for the first time, a right to privacy was identified in the United States Constitution.

Griswoldv.Connecticut was the beginning of a significant expansion of legal rights. Seven years later, in 1972, Eisenstadt v. Baird extended contraceptive access to unmarried individuals. Relying heavily on the privacy right outlined in both of the contraception decisions, Roe v. Wadein 1973 and Planned Parenthood of Southeastern Pennsylvania v. Caseyin 1993 affirmed the right to an abortion. Despite its limited focus, Griswold has come to be understood as a cornerstone of American reproductive and privacy rights.

Of course, those who spend their time working to preserve and expand civil liberties know that, in practice, these rights are neither secure nor universal.

Attempts to combine access to contraception and abortion are essentially omnipresent in American politics and law. The Court, the very same one (albeit with nine different justices in place) that 50 years ago affirmed the right to contraception, ruled last summer that “closely held” for-profit companies can, based on religious beliefs, decline to cover contraception through employer-sponsored insurance plans.

Financial and practical obstacles make it impossible for many to access reproductive care. Misinformation campaigns pervade our media and shape our law and policy. Burdensome requirements have forced the closure of health clinics, making access to the care and choice that the case law promises a fiction for many people. These laws hit hardest those who cannot afford to miss work or to travel, and who lack the flexibility to adapt to or evade these restrictions.

Stemming the tide of these barriers to equality continues to require significant time and effort from countless dedicated individuals and organizations.

It is hard work, but it is work worth doing to ensure that everyone has the ability to choose whether and when to have a child. Although we face persistent opposition, anniversaries such as this one can reinvigorate our efforts and remind us of our fitful progress.

The ACLU of Connecticut will mark the anniversary with our own branded contraceptives. Half a century ago, the commemorative Griswold v. Connecticut condoms sitting in the ACLU of Connecticut office would have warranted jail time.

Today, we celebrate how far we have come and remember how much further we have yet to go. This is a battle worth fighting, and we encourage every Connecticut resident to join us in the protection of women’s rights and the right to privacy, both of which were the result of Griswold v. Connecticut, decided 50 years ago on June, 7, 1965.

The D.C. Circuit Court of Appeals refused to reconsider an earlier decision that ruled the process for accommodating religious objections to the birth control benefit of the Affordable Care Act did not burden the group's rights.

Religiously affiliated nonprofits challenging the Affordable Care Act’s birth control benefit lost another legal battle this week as the D.C. Circuit Court of Appeals refused to rehear claims by Priests for Life charging the opt-out process unduly burdened their religious rights.

Priests for Life had asked the full D.C. Circuit Court of Appeals to review a ruling that the birth control benefit’s accommodation process did not violate the Religious Freedom Restoration Act, a federal law designed to shield certain conduct from regulatory overreach.

Judge Nina Pillard authored the November decision that unanimously upheld the accommodation. She wrote for the majority Wednesday in rejecting, again, claims by Priests for Life that the accommodation was unduly burdensome.

“Indeed, it bears emphasis that the whole point of the challenged regulation is to scrupulously shield objecting religious nonprofits from any role in making contraception available to women,” Pillard wrote. “The accommodation is itself evidence of the fundamental commitment of this Nation to religious freedom that RFRA embodies.”

This is the second loss this week for religious conservatives challenging the accommodation process to the ACA’s birth control benefit. The U.S. Court of Appeals for the Seventh Circuit on Tuesday rejected identical claims by the University of Notre Dame.

The Obama administration on Thursday notified the Roberts Court of its victories in a letter submitted by Solicitor General Donald Verrilli Jr.

In the one-page letter, the administration notes the decisions are the first from appeals courts to analyze the accommodation process in light of the Court’s ruling last summer in Hobby Lobby. The letter was filed in connection with Zubik v. Burwell, a case from the Third Circuit Court of Appeals challenging the accommodation process.

In that case, the Third Circuit rejected the claims from a religiously-affiliated nonprofit that the accommodation violated RFRA. Justice Samuel Alito in April put the Third Circuit decision on hold until the Department of Justice had replied to requests that the Supreme Court intervene in Zubik or until further order from the Court.

So far the Roberts Court has taken no action in Zubik since the April order.

The governor's executive action is in response to the failure of the GOP-majority state legislature to pass the so-called Louisiana Marriage and Conscience Act, which would codify discrimination of LGBTQ people by those who oppose marriage equality.

The executive action is in response to the failure of the GOP-majority state legislature to pass the so-called Louisiana Marriage and Conscience Act, which would codify discrimination of LGBTQ people by those who oppose marriage equality.

HB 707, sponsored by Rep. Mike Johnson (R-Bossier City), would have prohibited the state from taking action against a person, organization, or business if they acted in accordance with a religious belief or moral conviction about marriage.

The House Civil Law Committee voted 10-2 Tuesday to effectively kill the bill through a procedural move.

“There’s never a convenient time to stand up for liberty,” Johnson said after the bill’s defeat in committee, according to the New Orleans Advocate. “This issue’s not going away, though.”

As in Indiana and Arkansas, Louisiana faced a backlash against the legislation from LGBTQ advocates and those in the business community who warned the anti-gay policy would be bad for the bottom line.

Stephen Perry, the President and CEO of the New Orleans Convention and Visitors Bureau, told the Associated Press that the bill would make the state “complicit in officially state-sanctioned bigotry” and hurt the state’s economy to the tune of $65 million per year.

“We’re attempting to … carve out the ability to discriminate, the ability to be bigoted,” Perry said.

Businesspeople this spring in Indiana urged the Republican-dominated legislature there to vote against a discriminatory religious freedom bill, expressing similar sentiments about the impact of such a policy on the state’s economic health. The bill nevertheless passed, mostly along partisan lines.

Jindal issued a statement after signing the executive order, in which he said that the state should not be able to take adverse action against a person for their belief in so-called traditional marriage.

“That’s why I’m issuing an Executive Order to prevent the state from discriminating against people, charities and family-owned businesses with deeply held religious beliefs that marriage is between one man and one woman,” Jindal said. The order will remain valid from now until 60 days after the start of the next legislative session.

Jindal has criticized President Obama for issuing executive orders in response to the inability of Congress to pass legislation. Jindal issued a statement attacking the president’s executive action on immigration as bypassing Congress.

“Granting amnesty by executive order is wrong,” Jindal said of Obama’s immigration policy. “If the President wants to make the case that the law should be changed, he should go make the case to Congress and our people. This is an arrogant, cynical political move by the President, and it’s why so many Americans no longer trust this President to solve the problems we face.”

The executive order in Louisiana prohibits all departments, commissions, boards, agencies, and political subdivisions of the state from taking action against a person who “acts in accordance with his religious belief that marriage is or should be recognized as the union of one man and one woman.”

Micah Caswell, a spokesman for Equality Louisiana, said in a statement that Jindal was “abusing his executive power” and suggested that the governor cared more about his own presidential aspirations than about the people of Louisiana.

“Gov. Jindal is clearly trying to leave the biggest mess possible, as he readies himself to spend even less time in Louisiana and to launch his presidential campaign,” Caswell said. “In the end, his extreme ideology is only making the state a worse place for those of us who actually plan to live here past his last day in office.”

Jindal, over the past year, has courted the religious right while positioning himself for a possible GOP presidential campaign.

Jindal announced Monday that he is forming an exploratory committee while he considers a possible campaign for the Republican nomination for president, reported the New York Times.

“While other Republican leaders are talking about change, I’ve published detailed plans to repeal and replace Obamacare, rebuild America’s defenses, make America energy independent, and reform education for our nation’s children,” Jindal wrote in an email to supporters.

The decision released Tuesday is a strong endorsement of the Obama administration's accommodation process for religiously affiliated nonprofits that object to providing contraception in health-care plans.

The ACA requires some employers to offer health insurance plans that cover contraception as part of a package of preventive care services provided to employees at no additional cost or co-pay. The health law includes an exemption for churches and other houses of worship. It also contains an accommodation process for religiously affiliated nonprofits, like Notre Dame, that are not churches but maintain a religious objection to providing plans with contraception coverage.

That process allows the objecting employers to complete a form that notifies the federal government of their religious objection and triggers a process whereby the insurance company contracts directly with the people who want contraception coverage at no additional cost.

Under the accommodation process, groups like Notre Dame that claim a religious objection to the birth control benefit must simply notify the administration of their objection. The administration then takes on the task of coordinating coverage between insurance providers and those who want contraception coverage.

Notre Dame and other religiously affiliated nonprofits objected to this requirement, arguing that simply filling out the form to notify its insurance company, or other relevant third parties, violates its religious beliefs by making it complicit in a scheme it finds morally objectionable: providing contraception to university employees and students.

Tuesday’s decision was the first of those opinions to come back following the Roberts Court’s order to reconsider, and it is a strong repudiation of the religiously affiliated nonprofits claims. In a 2-1 decision, a panel of judges from the Seventh Circuit Court of Appeals rejected Notre Dame’s claims that participating in the accommodation process substantially burdened its religious rights.

Judge Richard Posner, writing for the majority, rejected the university’s claims that the Hobby Lobby decision means courts must take at face value claims of religious burden, stating “[a]lthough Notre Dame is the final arbiter of its religious beliefs, it is for the courts to determine whether the law actually forces Notre Dame to act in a way that would violate those beliefs.”

Posner noted that Notre Dame was effectively asking the court to block the university’s insurance provider from contracting with a third party—the Obama administration—to provide contraception coverage.

Unlike Notre Dame, those insurance companies have not raised religious objections to the birth control benefit. They are not even parties to the litigation. “It is irregular, moreover, for a court to be asked to enjoin nonparties,” Posner wrote. “For all we know, Aetna and its subsidiary value the opportunity to provide contraception coverage with generous reimbursement by the federal government.”

“Their business is providing health care, health care administration, and health insurance, and Notre Dame wants unilaterally to exclude them from a possibly lucrative chunk of that business,” said Posner.

Posner also rejected outright Notre Dame’s claims that the government has a myriad of other ways to accomplish its contraception coverage goals, such as directly providing contraception to those employees who want it.

“The very word ‘accommodation’ implies a balance of competing interests; and when we compare the burden on the government or third parties of having to establish some entirely new method of providing contraceptive coverage with the burden on Notre Dame of simply notifying the government that the ball is now in the government’s court, we cannot conclude that Notre Dame has yet established its right to the injunctive relief that it is seeking before trial,” Posner wrote.

In a concurring opinion, Judge David Hamilton answered the Supreme Court’s request to reconsider its earlier decision in favor of the Obama administration more directly than Posner’s opinion. “The accommodation for religious not-for-profits like Notre Dame played a pivotal role in Hobby Lobby,” Hamilton wrote, “but not in a way that helps Notre Dame in this case.”

Hamilton calls for a trial on the merits where the Notre Dame’s claims can be fully dissected. “Federal courts are not required to treat Notre Dame’s erroneous legal interpretation as beyond their reach—even if that interpretation is also a sincere and religious belief,” wrote Hamilton. “Notre Dame is not entitled to nullify the law’s benefits for others based on this mistake of law, which is the foundation of its claim of a substantial burden.”

The Notre Dame challenge is unique. Of the hundreds of lawsuits filed challenging the contraception benefit, it was the first, and so far only, to include attorneys representing the interests of those most affected by the law’s requirement: students and employees.

Americans United (AU) for Separation of Church and State intervened in the case on behalf of three anonymous Notre Dame students, saying the Seventh Circuit Court of Appeals should stick to its original ruling. Gregory Lipper, senior litigation counsel at AU, applauded the decision.

”The government has already relieved Notre Dame of any obligation to provide contraception coverage to anyone,” Lipper said. “As a result, the Seventh Circuit correctly concluded that Notre Dame has no right to stop third parties from stepping in to provide that coverage to employees and students. Nothing in the Religious Freedom Restoration Act allows Notre Dame to control the behavior of others, especially when it comes to something as important as reproductive health care.”

]]>http://rhrealitycheck.org/article/2015/05/20/notre-dame-loses-legal-battle-birth-control-benefit/feed/28Report: Insurers Are Violating Obamacare Rules on More Than Just Birth Controlhttp://rhrealitycheck.org/article/2015/05/01/report-insurers-violating-obamacare-rules-just-birth-control/?utm_source=rss&utm_medium=rss&utm_campaign=report-insurers-violating-obamacare-rules-just-birth-control
http://rhrealitycheck.org/article/2015/05/01/report-insurers-violating-obamacare-rules-just-birth-control/#commentsFri, 01 May 2015 20:04:20 +0000http://rhrealitycheck.org/?p=58190

The National Women's Law Center found that many insurers aren't properly covering birth control, maternity care, preventive services, and care related to gender transition.

Some insurance companies are violating the law by offering women incomplete health coverage under the Affordable Care Act (ACA), according to two new reports from the National Women’s Law Center (NWLC).

The ACA was designed to end the practice of forcing women to pay more for their insurance simply because they are women. The health law required insurers to cover maternity care, and to charge no copays for preventive services like birth control, breastfeeding support, and well-woman visits.

But in a survey of more than 100 insurers in 15 states, NWLC found a wide range of violations to the law.

These violations are making some women pay more for health care than they should, the report says, and could jeopardize health outcomes for women or their infants. Insurance companies also failed almost across the board to offer adequate coverage for transgender people.

The NWLC findings on birth control echo those of the Kaiser Family Foundation just a few weeks ago. Both organizations found that, in violation of the law, some insurers only cover generic birth control pills or aren’t fully covering non-pill birth control methods like the vaginal ring or IUD. NWLC found that some plans improperly charge for services like family planning counseling or follow-up appointments after an IUD insertion.

Both also found that despite the ACA’s requirements, no companies reviewed had a clear waiver process for women who need a specific birth control method that isn’t covered under their plan. Women are told to go through the agency’s existing claims processes, which either don’t solve the problem or take too long for such a time-sensitive medical need.

NWLC, along with the insurance plans they reviewed, heard from women in all 50 states through their national hotline:

These women have spent hours on the phone with their insurance company trying to find out why they still have to pay for their birth control. They often are given conflicting information about their coverage by the insurance company. And, too often, the insurance company tells them their method of birth control simply is not covered, or that they should switch birth control methods if they do not want to pay out-of-pocket for the method prescribed for them.

A total of 33 insurers out of more than 100 plans NWLC surveyed, in 13 out of the 15 states, had some kind of birth control coverage violation.

A handful of insurers across seven states denied women the full range of maternity coverage that they’re entitled to, which can “pose serious threats to women and newborns” if women forgo essential prenatal care due to high costs, the report says.

The United States has higher rates of preterm birth and infant mortality than other developed countries, and it’s also the only advanced economy in the world in which maternal mortality rates are rising.

Five insurers in three states—Colorado, South Dakota, and Alabama—broke the rules by limiting a woman’s number of ultrasounds or prenatal visits, restricting coverage based on age, or refusing to cover certain prenatal screening tests.

Two insurers in Tennessee and Ohio refused to cover maternity care for dependents. The ACA explicitly prohibits this since so many women of reproductive age are covered through a spouse or parent.

Six plans in three states deny maternity coverage outside of the plan’s service area, which would leave women who go into early labor while traveling without options.

Twenty plans in six states didn’t adequately cover breast pumps or breastfeeding counseling. Some didn’t cover the services at all, and some imposed things like time limits on how long a breast pump could be rented.

By far the most widespread violation was failing to cover transgender people, which breaks rules against discrimination based on sex, gender identity, or health condition. In 12 of the 15 states studied, 92 insurers explicitly excluded services or surgery related to gender transition.

And even though abortion coverage is severely limited under the ACA, Colorado still managed to violate the law by refusing to cover any abortion services for women who receive financial help with their premiums.

The NWLC report authors note that, given how extensive all of the different violations were in this sample, it’s likely that insurers in other states are also failing to live up to their obligations to women.

The violations may be honest mistakes and miscommunications, or they may be deliberate efforts to avoid paying for care. Either way, the reports say, federal and state regulators need to get better at enforcing the law and informing women of their rights, and insurers need to be much more transparent about the coverage they offer.